The hit Bollywood film “Toilet: A Love Story” highlights an important global health issue that affects the health of millions living in rural India. As part of my doctoral research in the southern Indian state of Tamil Nadu, I interviewed women from lower and middle castes living in a rural village to understand their perceptions of toilets.

These women imagined how their guests and neighbors would judge their homes, and many feared that they would feel ashamed if they had to ask guests to relieve themselves outside. Given the highly personal nature of toilets, experiences within one’s personal networks are likely to shape rural Indians’ decisions to build and use toilets.

To design effective sanitation policies, we must ask what motivates families to invest in this public health project.